A Forum for Orthodox Jewish thought on Halacha, Hashkafa, and the social issues of our time.

Sunday, September 02, 2012

Russian Roulette

Just when I thought there was nothing more to say on the
issue of Metzitza B’Peh (MbP), the cover story in Ami Magazine compels me to
comment.

The ultimate analogy to MbP is the following. Take a gun that
has a 1 million bullet capacity. Place one bullet in one of the chambers
leaving the rest empty. Take that gun,
point it at the head of your 8 day old infant and pull the trigger.

Is there a sane person in the world that would do that? I
think the answer is obvious.You would have to be literally
insane to do such a thing even though the odds of killing the baby are statistically
insignificant. Why would anyone do such a foolish thing? There is a loaded gun
and a chance that the bullet will end up in your child’s head!

And yet that is precisely the argument being made by those
who oppose the proposed New York City law requiring informed consent by parents
before allowing a Mohel to do Metzitza B’Peh. The argument is that the percentage of infants found to
have been infected by herpes due to MbP is statistically
so insignificant that requiring parents be informed about the danger is an unwarranted governmental interference in the practice of Judaism.

The logic of this argument truly escapes me. I wonder how
they would answer the question I posed? Would they tell you that you should
point a loaded gun to your child and pull the trigger? Even if the chances are
1 in a million that the bullet will not be fired? I think I know what their
answer would be.

Another argument they make is that there is no absolute incontrovertible
evidence connecting the herpes contracted by the infant to the Mohel. This is
true. Furthermore they say that in any case the Mohel washes his mouth out with
an antiseptic mouthwash like Listerine.

The problem with these arguments is that they lack any
common sense. Is there any question that
it is possible that a Mohel with an active herpes virus (unbeknownst to him) can
transmit it to a child via oral contact with an open wound? Even people with
the most rudimentary knowledge of medical science know that it is possible.The
fact that there is no conclusive proof that this was the case in the cases
cited above doesn’t mean that it didn’t happen. The circumstantial evidence
that they did pass it on to the infant was very persuasive to the CDC. Furthermore washing a mouth out with a strong
mouthwash like Listerine has only a limited effect on viruses. From an NIH website:

There is a clinical efficacy in utilizing an oral rinse with the anti microbial agent Listerine Antiseptic in reducing the viral the presence of viral contamination in oral fluids for at least 30 min. after oral rinse. The risk of viral cross contamination generated from these oral fluids in person to person contact... may be reduced.

My friends, performing MbP is playing Russian roulette with
your child’s life! Are you willing to pull that trigger?

And yet there is a religious argument to be made in favor of
it. This is what is really at stake here. Chasidim are adamant that MbP is an absolute
religious requirement! If I understand correctly - they view a Bris done
without MbP to be invalid! Leaving out the fact that that is certainly not the universal
view in Judaism – including the view of many Gedolim of the past and present,
let us grant them their right to believe that. They therefore argue that this
is a church-state issue.

The problem with this argument is that the constitutional right
to freedom of religion is not absolute. When there is a compelling interest of
society that contradicts a religious ritual, the government has a right to interfere. To put this point in stark relief I will use
an extreme example. If there was a religion that required human sacrifice, the
government would certainly be within its rights to legislate against it. While
MbP is nowhere near human sacrifice, the principle is the same. Where to draw
the line of “compelling interest” is beyond my pay-scale and I will leave it to
constitutional scholars to sort out.

That said, I would be opposed to the government legislating
against doing MbP. That it is considered so vital by so large a
segment of Jewry combined by the low probability of a child ever contracting herpes moves me
to oppose it. In this case I do feel that banning the procedure would be an
unconstitutional impediment to freedom of religion.

But that is not the law being proposed. The law being proposed
is a requirement for parents to be informed of the dangers. That means that not
a single parent would be denied the opportunity for their child to be circumcised
with the accompanying MbP. The only difference would be that parents would know
that there are risks attached – small though they may be.

One of the most upsetting things in the Ami article is their
characterizing this law as an “anti circumcision” law. I have to protest that characterization.
No one in the United States has ever suggested that the government ban circumcision
itself except for some on the fringes of society. Not only that, but the American Academy of Pediatrics who has been studying this issue long term has just concluded
that the health benefits of circumcision outweigh the possible risks. Having
been neutral in the past - they now advocate it. It is therefore incorrect to say that this is all about banning Bris
Milah.

One of the more incredible arguments I read in that Ami article
is the assertion that the Mohalim are the experts here and not the CDC whose studies and reports on herpes infected infants are behind the proposed NY legislation. Yes, Mohalim are experts in
the procedure. But they are ignoramuses about Herpes and how it infects a
newborn. Calling them experts on this issue is a shocking assertion to my mind.

What about the slippery slope argument? … if you start
legislating MbP – actual Bris Mila will be next? That’s like saying cars will
be banned if we start legislating safe driving laws.

And finally asking people to sign an informed consent form before
MbP is performed is no different than asking a heart patient to sign an informed
consent form before open heart surgery. Signing an informed consent form does not
equate to interfering in either MbP or surgery.

This is important legislation. There are circumcisions being
performed multiple times every day in this country. Most of them are done in
the city of New York. Until recently I would be willing to bet that the vast
majority of parents about to have their son circumcised had never heard of MbP.
The way most people chose a Mohel is by reputation. They had no clue about the
actual procedure – certainly not the MbP aspect of it. They just assume that
the Mohel they hired will do a great job based on his reputation and
experience. In the vast majority of those cases that is what happens.

Although MbP has been in the news over the last few years, I’d
be willing to bet that a lot of people still don’t what it is or what the risks
are. This legislation will enable them to make an informed decision about it.
There is nothing wrong with that. My guess is that the phenomenon of “moving to
the right” will result in most parents still opting for MbP.

I believe that at least some of the motivation behind this opposition
is not the fear that Chasidim or other Charedim will opt out of MbP. They are
afraid that informed consent in other segments of Jewry will make them to
decide to opt out of it. And therefore out of what they believe to be an essential
part of a Bris. And that ultimately parents will be frightened out of what was
a centuries old part of Bris Milah.

My answer to them is that it is not their job to decide what
is Halachicly permissible for Jews outside of their own community. It is far
more important for people to know the truth.

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About Me

My outlook on Judaism is based mostly on the teachings of my primary Rebbe, Rabbi Aaron Soloveichik from whom I received my rabbinic ordination. It is also based on a search for spiritual truth. Among the various sources that put me on the right path, two great philosophic works stand out: “Halakhic Man” and “Lonely Man of Faith” authored by the pre-eminent Jewish philosopher and theologian, Rabbi, Dr. Joseph B. Soloveitchik. Of great significance is Rabbi, Dr. Norman Lamm's conceptualization and models of Torah U’Mada and Dr. Eliezer Berkovits who introduced me to the world of philosophic thought. Among my early influences were two pioneers of American Elementary Torah Chinuch, Rabbis Shmuel Kaufman and Yaakov Levi. The Yeshivos I attended were Yeshivas Telshe for early high school and more significantly, the Hebrew Theological College where for a period of ten years, my Rebbeim included such great Rabbinic figures as Rabbis Mordechai Rogov, Shmaryahu Meltzer, Yaakov Perlow, Herzl Kaplan, and Selig Starr. I also attended Roosevelt University where I received my Bachelor's Degree - majoring in Psychology.